Return to flip book view

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l Auction Edge, Inc. Employee Benefits Enrollment Guide Plan Year: January 1, 2023 – December 31, 2023

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 2 We know that your benefits are important to you and your family. Helping you understand the benefits offered by Auction Edge, Inc. is important to us. That is why we have created this Benefit Guide. Included in this guide are summary of the benefits, cost information, and contact information for each provider. It is important to remember that only those benefit programs for which you are eligible and have enrolled in apply to you. We encourage you to review each section and to discuss your benefit options with your family members. Be sure to pay close attention to applicable co-payments and deductibles, along with networks and services that may be limited or not covered (exclusions). This guide is not a contract between you and Auction Edge, Inc. It is not intended to cover all provisions of all plans but rather is a quick reference to help answer most of your questions. Please see each Benefits Summary Plan Description for complete details. We hope this guide will give you a clear explanation of your benefits and help you be better prepared for the enrollment process. Enrollment ............................................................................................ Page 3 Medical ................................................................................................. Page 4 Preventative Care .................................................................................. Page 9 Dental .................................................................................................. Page 10 Vision ................................................................................................... Page 14 Group Term Life .................................................................................... Page 17 Voluntary Life ........................................................................................ Page 18 Voluntary Life Rates ............................................................................... Page 19 Mass Mutual Whole Life .......................................................................... Page 22 Short Term Disability ............................................................................. Page 23 Long Term Disability .............................................................................. Page 24 Accident ............................................................................................... Page 25 Critical Illness ....................................................................................... Page 26 Notes ................................................................................................... Page 31 Contact Information .............................................................................. Page 32 TABLE OF CONTENTS WELCOME

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 3 HOW TO ENROLL Open Enrollment The first step is to review your current benefit elections. Verify your personal information and make any changes if necessary. Newly Eligible Make your benefit elections and complete the enrollment paperwork. Once you have made your elections, you will not be able to change them until the next open enrollment period unless you have a qualified change in status. WHEN TO ENROLL Open Enrollment Open enrollment period runs from December 1, 2022 through December 7th, 2022. The benefits you elect during open enrollment will be effective from January 1, 2023 through December 31, 2023. Newly Eligible You become eligible for coverage on the first of the month following your date of hire. Your current coverages will end if you no longer meet the eligibility requirements, your contributions are discontinued, or the group policy is terminated. Qualifying Events Employees are able to enroll or make changes to their benefits elections during the group’s annual open enrollment period. Once you elect an option you are bound to the decision for the entirety of the plan year unless you have a “qualifying event”. Employees have 30 days from the date of the qualifying event to add or change coverage. These may include, but are not limited to: · Changes in your employment status · Changes in your legal marital status · Change in number of dependents · Taking an unpaid leave of absence · Dependent satisfies or cease to satisfy eligibility requirement · Family Medical Leave Act (FMLA) leave · A COBRA qualifying event · Entitlement to Medicare or Medicaid · A change in the place of residence of the employee, resulting in the current carrier not being available ENROLLMENT

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 4 Auxiant In-Network Non-Network Deductible (Calendar Year—Embedded ) Single $3,000 $3,000 Family $9,000 $9,000 Out-Of-Pocket Maximums (includes deductible) Single $6,850 Unlimited Family $13,700 Unlimited Co-Insurance (plan pays after deductible) 80% 50% Annual Maximum Benefit Unlimited Preventive Care Health Care reform preventative screenings, labs, etc. (See preventative schedule from carrier or full details) Covered at 100% not subject to deductible You pay 50% after deductible Physicians Services Office Visits You pay $40 copay then 20% You pay 50% after deductible Specialist Visits You pay $40 copay then 20% You pay 50% after deductible Urgent Care & Emergency Services Urgent Care You pay $40 copay then 20% You pay 50% after deductible Emergency Room Services: Fa-cility/Other covered services You pay $200 Copay then 20% Prescription Drugs - 30 Day Supply Generic Drugs You pay $10 copay N/A Preferred Brand Name Drugs You pay $35 copay N/A Non-Preferred Brand Name Drugs You pay $70 copay N/A Specialty Drugs You pay $250 copay N/A Prescription Drugs - 90 Day Supply Generic Drugs You pay $20 copay N/A Preferred Brand Name Drugs You pay $70 copay N/A Non-Preferred Brand Name Drugs You pay $140 copay N/A Specialty Drugs N/A N/A Benefits include but are not limited to: Network Non-Network Maternity You pay 20% after deductible You pay 50% after deductible Inpatient/Outpatient Professional Services You pay 20% after deductible You pay 50% after deductible Inpatient Facility Services (per admission) You pay 20% after deductible You pay 50% after deductible Outpatient Services (per visit) You pay $40 copay You pay 50% after deductible Ambulance Services You pay 20% after deductible You pay 20% after deductible Telemedicine / Virtual Visits You pay $40 copay then 20% You pay 50% after deductible Coverage Options Employee Costs Per Paycheck Employee Only $23.14 Employee + Spouse $309.27 Employee + Child(ren) $240.76 Employee + Family $548.45 Employee + Spouse + 1 Child (for grandfathered employees ONLY) $473.23 EE + 1 Child (for grandfathered employees ONLY) $180.24 MEDICAL - PPO Plan

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 5

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 6

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 7

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 8

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 9 PREVENTATIVE CARE WHICH PREVENTATIVE CARE SERVICES ARE COVERED? Understanding the full value of covered benefits allows you to take responsibility for maintaining good health and incorporating healthy habits into your lifestyle. Some examples include getting regular physical examinations, mammograms and immunizations. Through the plans offered by Auction Edge, Inc, all covered individuals and family members are eligible to receive routine wellness services like these, at no cost; all copays, coinsurance, and deductibles are waived. The US Preventive Services Task Force maintains a regular list of recommend-ed services that all Affordable Care Act (i.e. Health Care Reform) compliant in-surance plans should cover at 100% for in-network providers. Below is a list of common services that are included in the plans offered this year: • Routine Physical Exam • Well Baby and Child Care • Well woman Visits • Immunizations • Routine Bone Density Test • Routine Breast Exam • Routine Gynecological Exam • Screening for Gestational Diabetes • Obesity Screening and Counseling • Routine Digital Rectal Exam • Routine Colonoscopy • Routine Colorectal Cancer Screening • Routine Prostate Test • Routine Lab Procedures • Routine Mammograms • Routine Pap Smear • Smoking Cessation • Health Education/Counseling Services • Health Counseling for STDs and HIV • Testing for HPV and HIV • Screening and Counseling for Domestic Violence “An ounce of prevention is worth a pound of cure.”

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 10 DENTAL BENEFITS Lincoln Financial Group Plan Features Dental PPO Plan IN-NETWORK (Dental Connect) Annual Deductible Calendar Year (Individual / Family) $50 / $150 Preventive Care (Exams, Cleanings, X-rays, Fluoride under age 13, Seal-ants, Maintainers) 100% Basic Procedures ( Fillings, Simple Extractions, Periodontal. Periodontal Surgery, Oral Surgery) 90% Major Procedures (Root Canal, Crowns, Dentures, Bridges, Repairs, Im-plant) 50% Calendar Year Maximum Benefit $2,000 EMPLOYEE COST PER PAYCHECK Employee $1.56 Employee + Spouse $18.84 Employee + Child(ren) $20.20 Employee + Family $40.94 *Out-of-Network benefits pay at the 90th percentile of usual and customary fees.

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 11

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 12

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 13

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 14 VISION BENEFITS Lincoln Financial Group Plan Features Vision Plan IN-NETWORK (Vision Connect) Vision Exam $20 Copay Lenses Single / Bifocal / Trifocal / Lenticular $20 Copay Materials $20 Copay Frames $130 Allowance then 30% at participating providers Contact Lenses – Elective / Necessary $125 Copay / Covered in full after eyewear copay Contact Fitting & Evaluation Not Covered Frequency (Months) Exam Every 12 Months Lenses Every 12 Months Frames Every 24 Months Contacts Every 12 Months Either glasses or contacts allowed per frequency OUT-OF-NETWORK Vision Exam Up to $40 allowance Lenses Single / Bifocal / Trifocal $40 / $80 / $80 / Copay Frames $45 Allowance Contact Lenses – Elective / Necessary $125 Allowance / $210 Allowance EMPLOYEE COST PER PAYCHECK Employee $0.14 Employee + Spouse $1.45 Employee + Child(ren) $1.93 Employee + Family $3.25

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 15

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 16

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 17 GROUP TERM LIFE BENEFITS Lincoln Financial Group Plan Features Basic Life/AD&D Insurance Employee Benefit Amount $20,000 AD&D Benefit $20,000 Age Reduction Schedule: Age Band Benefit Reduction 65 35% of original amount 70 An additional 15% of original amount As an employee of Auction Edge, Inc. Basic Life/AD&D insurance is provided at NO COST TO YOU!

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 18 VOLUNTARY LIFE BENEFITS Lincoln Financial Group Plan Features Voluntary Life Insurance Employee Benefit Amount Employees can elect amounts in increments of $10,000. Minimum Benefit Amount $10,000 increments Maximum Benefit Amount Not to exceed 5 times the employee’s annual salary, or $500,000 Guaranteed Issue Amount $150,000 Spouse Benefit Amount Spouses can elect amounts in increments of $5,000. Minimum Benefit Amount $5,000 increments Maximum Benefit Amount Guaranteed Issue Amount not to exceed 2.5 times the employee’s annual salary or 50% of the employee’s benefit amount, or $250,000 $30,000 Dependent Benefit Amount Up to $10,000 in increments of $2,000 ($1,000 day 1 to 6 months) age limit is 26) Maximum Benefit Amount Guaranteed Issue Amount $10,000 $10,000 Employee, Spouse, Dependent Accidental Death & Dismemberment AD&D Same coverage as elected for Voluntary Life above

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 19 VOLUNTARY LIFE RATES Employee Semi-Monthly Premium Non-Smoker Life & Accidental Death & Dismemberment Premium for sample benefit amounts • Employee and Spouse premiums are calculated separately based on the employees age. • Refer to Program Specifications for your maximum benefit amounts. AGE Semi—Monthly RATE Per $1000 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 <25 0.0225 $0.23 $0.45 $0.68 $0.90 $1.13 $1.35 $1.58 $1.80 $2.03 $2.25 25-29 0.0265 $0.27 $0.53 $0.80 $1.06 $1.33 $1.59 $1.86 $2.12 $2.39 $2.65 30-34 0.0325 $0.33 $0.65 $0.98 $1.30 $1.63 $1.95 $2.28 $2.60 $2.93 $3.25 35-39 0.0450 $0.45 $0.90 $1.35 $1.80 $2.25 $2.70 $3.15 $3.60 $4.05 $4.50 40-44 0.0620 $0.62 $1.24 $1.86 $2.48 $3.10 $3.72 $4.34 $4.96 $5.58 $6.20 45-49 0.0985 $0.99 $1.97 $2.96 $3.94 $4.93 $5.91 $6.90 $7.88 $8.87 $9.85 50-54 0.1520 $1.52 $3.04 $4.56 $6.08 $7.60 $9.12 $10.64 $12.16 $13.68 $15.20 55-59 0.2475 $2.48 $4.95 $7.43 $9.90 $12.38 $14.85 $17.33 $19.80 $22.28 $24.75 60-64 0.3955 $3.96 $7.91 $11.87 $15.82 $19.78 $23.73 $27.69 $31.64 $35.60 $39.55 65-69 0.6940 $6.94 $13.88 $20.82 $27.76 $34.70 $41.64 $48.58 $55.52 $62.46 $69.40 70-74 1.2530 $6,500 $13,000 $19,500 $26,000 $32,500 $39,000 $45,500 $52,000 $58,500 $65,000 $12.53 $25.06 $37.59 $50.12 $62.65 $75.18 $87.71 $100.24 $112.77 $125.30 75-79 2.5365 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 $25.37 $50.73 $76.10 $101.46 $126.83 $152.19 $177.56 $202.92 $228.29 $253.65 Benefits and premium amounts reflect age reductions.

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 20 VOLUNTARY LIFE RATES Employee Semi-Monthly Premium Smoker Life & Accidental Death & Dismemberment Premium for sample benefit amounts • Employee and Spouse premiums are calculated separately based on the employees age. • Refer to Program Specifications for your maximum benefit amounts. AGE Sem—Monthly RATE Per $1000 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 <25 0.0340 $0.34 $0.68 $1.02 $1.36 $1.70 $2.04 $2.38 $2.72 $3.06 $3.40 25-29 0.0390 $0.39 $0.78 $1.17 $1.56 $1.95 $2.34 $2.73 $3.12 $3.51 $3.90 30-34 0.0485 $0.49 $0.97 $1.46 $1.94 $2.43 $2.91 $3.40 $3.88 $4.37 $4.85 35-39 0.0720 $0.72 $1.44 $2.16 $2.88 $3.60 $4.32 $5.04 $5.76 $6.48 $7.20 40-44 0.1095 $1.10 $2.19 $3.29 $4.38 $5.48 $6.57 $7.67 $8.76 $9.86 $10.95 45-49 0.1735 $1.74 $3.47 $5.21 $6.94 $8.68 $10.41 $12.15 $13.88 $15.62 $17.35 50-54 0.2925 $2.93 $5.85 $8.78 $11.70 $14.63 $17.55 $20.48 $23.40 $26.33 $29.25 55-59 0.4120 $4.12 $8.24 $12.36 $16.48 $20.60 $24.72 $28.84 $32.96 $37.08 $41.20 60-64 0.6160 $6.16 $12.32 $18.48 $24.64 $30.80 $36.96 $43.12 $49.28 $55.44 $61.60 65-69 1.0295 $10.30 $20.59 $30.89 $41.18 $51.48 $61.77 $72.07 $82.36 $92.66 $102.95 70-74 1.8905 $6,500 $13,000 $19,500 $26,000 $32,500 $39,000 $45,500 $52,000 $58,500 $65,000 $18.10 $36.19 $54.29 $72.38 $90.48 $108.57 $126.67 $144.76 $162.86 $180.95 75-79 3.2730 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 $32.73 $65.46 $98.19 $130.92 $163.65 $196.38 $229.11 $261.84 $294.57 $327.30 Benefits and premium amounts reflect age reductions.

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 21 VOLUNTARY LIFE RATES Spouse Semi-Monthly Premium Uni-Smoker Life & Accidental Death & Dismemberment Premium for sample benefit amounts • Employee and Spouse premiums are calculated separately based on the employees age. • Refer to Program Specifications for your maximum benefit amounts. AGE Sem—Monthly RATE Per $1000 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 <25 0.0310 $0.16 $0.31 $0.47 $0.62 $0.78 $0.93 $1.09 $1.24 $1.40 $1.55 25-29 0.0355 $0.18 $0.36 $0.53 $0.71 $0.89 $1.07 $1.24 $1.42 $1.60 $1.78 30-34 0.0445 $0.22 $0.45 $0.67 $0.89 $1.11 $1.34 $1.56 $1.78 $2.00 $2.23 35-39 0.0650 $0.33 $0.65 $0.98 $1.30 $1.63 $1.95 $2.28 $2.60 $2.93 $3.25 40-44 0.0930 $0.47 $0.93 $1.40 $1.86 $2.33 $2.79 $3.26 $3.72 $4.19 $4.65 45-49 0.1455 $0.73 $1.46 $2.18 $2.91 $3.64 $4.37 $5.09 $5.82 $6.55 $7.28 50-54 0.2270 $1.14 $2.27 $3.41 $4.54 $5.68 $6.81 $7.95 $9.08 $10.22 $11.35 55-59 0.3480 $1.74 $3.48 $5.22 $6.96 $8.70 $10.44 $12.18 $13.92 $15.66 $17.40 60-64 0.5950 $2.98 $5.95 $8.93 $11.90 $14.88 $17.85 $20.83 $23.80 $26.78 $29.75 65-69 1.0165 $5.08 $10.17 $15.25 $20.33 $25.41 $30.50 $35.58 $40.66 $45.74 $50.83 70-74 1.8105 $9.05 $18.11 $27.16 $36.21 $45.26 $54.32 $63.37 $72.42 $81.47 $90.53 75-79 3.6265 $18.13 $36.27 $54.40 $72.53 $90.66 $108.80 $126.93 $145.06 $163.19 $181.33 This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency. Dependent Semi-Monthly Premium Premium covers all dependent children regardless of the number of children. Dependent Children Benefit $1,000 Semi Monthly Child(ren) Rate $ 0.20 Employee AD&D per $1,000 Semi Monthly $0.0145 Spouse AD&D per $1,000 Semi-Monthly $0.015 Child AD&D per $1,000 Semi-Monthly $0.017

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 22

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 23 SHORT TERM DISABILITY Short term disability insurance provides you with short term income protection if you become disabled due to a covered injury, illness or pregnancy. Employee Benefit Amount 60% of Pre-Disability Earnings Maximum Benefit Amount $1,000 Elimination Period (Accident) 14 days Elimination Period (Sickness; includes pregnancy) 14 days Benefit Duration 11 weeks Voluntary Short-Term Disability Lincoln Financial Group / Plan Features $ x 0.6 = $ / 10 x = $ / 2 $ Weekly Earnings % of Salary Weekly Benefit Rate Monthly Premium Premium Per Paycheck Cost per Paycheck Formula Age Premium Factor 25-29 $0.145 30-34 $0.13 35-39 $0.13 40-44 $0.145 45-49 $0.155 50-54 $0.18 55-59 $0.23 60-64 $0.28 65-69 $0.315 70-74 $0.315 0-24 $0.13

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 24 LONG TERM DISABILITY Long term disability insurance provides you with long term income protection if you become disabled due to a covered injury, illness for an extended period. As a full-time eligible em-ployee of Auction Edge, Inc., Long Term Disability coverage is provided at NO COST TO YOU! All Active Full Time Employees Own occupation period, 24 months Employee Benefit Amount 60% of Pre-Disability Earnings Maximum Benefit Amount $10,000 Elimination Period 90 Days Benefit Period Later of age 65 or Social Security Normal Re-tirement Age Group Long-Term Disability Lincoln Financial Group / Plan Features

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 25 ACCIDENT INSURANCE VOLUNTARY ACCIDENT INSURANCE BENEFITS ARE PROVIDED BY Lincoln Financial Group Accident insurance coverage provides full-time employees with a lump sum benefit based on covered injuries you sustain off the job and the treatment you need. Lincoln Financial Group Benefit Type Insurance Pays You INJURIES Fractures $450-$3,500 (depending on bone) Dislocations $450-$2,625 (depending on location) or 25% for partial dislocation Second – and Third-Degree Burns $100-$10,000 (depending on severity) Concussions $150 Cuts/Lacerations $73-$400 Eye Injuries $150 or $300 MEDICAL SERVICES & TREATMENT Ambulance $225 Ambulance/$1,125 Air Emergency Room $150 Non-Emergency Care $75 Physical Follow-Up $75 Therapy Services (including Physical Therapy) $35 Medical Testing Benefit $200 Medical Appliances $75-$750 (depending on appliance) Inpatient Surgery $150-$1,500 HOSPITAL COVERAGE Admission $1,000 Confinement $200 Inpatient Rehab (paid per accident) $150 HEALTH SCREENING BENEFIT Health Screening N/A EMPLOYEE COST PER PAYCHECK Employee $4.76 Employee + Spouse $7.78 Employee + Child(ren) $8.35 Employee + Family $11.33 Your insurance company already paid the doctor… this money is paid directly to you.

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 26 CRITICAL ILLNESS INSURANCE VOLUNTARY CRITICAL INSURANCE BENEFITS ARE PROVIDED BY Lincoln Financial Group Critical illness insurance coverage provides full-time employees with a lump sum benefit Lincoln Financial Group Benefit Type Insurance Pays You COVERAGE FOR AMOUNT Employee $10,000 / $15,000 /$20,000 Spouse $5,000 / $7,500 /$10,000 Health Screening $50 per calendar year Child $2,500 / $5,000 /$10,000 Covered Conditions Initial Benefit Recurrence Benefit COVERAGE FOR AMOUNT AMOUNT Invasive Cancer 100% 100% Non-Invasive Cancer 25% 100% Arterial/ Vascular Disease 25% 100% Heart Attack 100% 100% Stroke 100% 100% Coronary Artery Bypass Graft 50% 100% Kidney Failure 100% none End Stage Renewal Failure 100% 100% Major Organ Failure 100% 100% Infectious Disease with Hospitalization (COVID-19, Tetanus, etc.) 25% none Progressive Disease (Alzheimer's, Multiple Sclerosis, Lupus, etc.) 100% none Your insurance company already paid the doctor… this money is paid directly to you.

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 27 CRITICAL ILLNESS INSURANCE Child Per Pay Rate: $0.144 per $1,0000 Per Paycheck Premium Deductions Employee (Non-Tobacco) Attained Age $10,000 $15,000 $20,000 < 25 $0.79 $1.19 $1.58 25-29 $1.24 $1.86 $2.48 30-34 $1.68 $2.51 $3.35 35-39 $2.18 $3.27 $4.36 40-44 $3.15 $4.73 $6.30 45-49 $4.19 $6.28 $8.37 50-54 $5.87 $8.81 $11.74 55-59 $7.93 $11.90 $15.86 60-64 $11.06 $16.59 $22.12 65-69 $15.07 $22.61 $30.14 70 + $30.07 $45.11 $60.14 Per Paycheck Premium Deductions Employee (Tobacco) Attained Age $10,000 $15,000 $20,000 < 25 $0.85 $1.28 $1.70 25-29 $1.38 $2.06 $2.75 30-34 $1.96 $2.94 $3.92 35-39 $2.76 $4.13 $5.51 40-44 $4.44 $6.66 $8.88 45-49 $6.69 $10.03 $13.37 50-54 $10.49 $15.73 $20.97 55-59 $15.59 $23.38 $31.17 60-64 $23.66 $35.49 $47.32 65-69 $34.48 $51.72 $68.96 70 + $56.28 $84.42 $112.56 Per Paycheck Premium Deductions Spouse (Non-Tobacco) Attained Age $5,000 $7,500 $10,000 < 25 $0.40 $0.59 $0.79 25-29 $0.62 $0.93 $1.24 30-34 $0.84 $1.26 $1.68 35-39 $1.09 $1.64 $2.18 40-44 $1.58 $2.36 $3.15 45-49 $2.09 $3.14 $4.19 50-54 $2.94 $4.40 $5.87 55-59 $3.97 $5.95 $7.93 60-64 $5.53 $8.30 $11.06 65-69 $7.54 $11.30 $15.07 70 + $15.04 $22.55 $30.07 Per Paycheck Premium Deductions Spouse (Tobacco) Attained Age $5,000 $7,500 $10,000 < 25 $0.43 $0.64 $0.85 25-29 $0.69 $1.03 $1.38 30-34 $0.98 $1.47 $1.96 35-39 $1.38 $2.07 $2.76 40-44 $2.22 $3.33 $4.44 45-49 $3.34 $5.01 $6.69 50-54 $5.24 $7.86 $10.49 55-59 $7.79 $11.69 $15.59 60-64 $11.83 $17.75 $23.66 65-69 $17.24 $25.86 $34.48 70 + $28.14 $42.21 $56.28

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 28

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 29

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 30

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 31 NOTES

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 32 The informaon in this Enrollment Guide is presented for illustrave purposes and is based on informaon provided by the employer. The text contained in this Guide was taken from various summary plan descripons and benefit informaon. While every effort was taken to accurately report your benefits, dis-crepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents the actual plan documents will prevail. All informaon is confidenal, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any quesons about your Guide, contact Human Resources. Auxiant Customer Service 800-245-0533 www.auxiant.com Network: Cigna Lincoln Financial Group Customer Service 800-423-2765 www.lfg.com Network: Dental: Dental Connect Vision: Vision Connect CONTACT INFORMATION Title Name Email Phone Number Director of Sales Joe Turi jturi@keystoneinsgrp.com 216-217-4185 Senior Account Manager Kassi Alsip kalsip@keystoneinsgrp.com 574-406-6914 Account Coordinator Rodney Pritchard rpritchard@keystoneinsgrp.com 574-406-6919 Benefits Coordinator Zach Chupp zchupp@keystoneinsgrp.com 574-231-6526 Serviceteam@keystoneinsgrp.com 574-231-6500 877-691-5424 Agent Nathan Davis ndavis@robinsins.com 615-665-9200 Service Team General Copyright © Keystone Benefits - all rights reserved If you need assistance regarding your benefits, please see Human Resources. Otherwise, please contact your group Account Manager, Kassi Alsip, for assistance.

This benefit guide only provides a summary of your group’s benefits. All lines of coverage described are subject to the definitions, limitations and exclusions set in each insurance carrier or providers contract. Page l 33 13800 Jackson Rd Mishawaka | IN 46544 keystoneinsgrp.com Copyright © Keystone Benefits - all rights reserved